99120144 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY 2.c
CITY OF CUPERTINO BUILDING-FIXCfRICAL PERMIT NO.
OF
DIVISION APPLICATIONIPERMIT KUMBING-MFCIIANICAL
PUIIAHNG PROJECT IDENTIFICATION
SANITARY NO. APPLICATION SUBrurrAL DATE
BUILDING ADDRISS: oW kilo �� i �^�� ��
,/ 1
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Na
PHONE i CgyTRA ( \ME: - LIC NO:
NIC CONTROL If
Nall LIC O. —A,xfDD1tE51: ❑
ACP' PHONH: 5,1 BUILDING PERMIT INFO
,^ S ❑ C0nsukan1 Pecs Paid by Applicant(Initial) I LI CIG EI,Iigr Evil- eG
LICENSED CONTRACTOR'S DECLARATION QTy ELECTRIC PERMIT FEE
I htcby ufrmh mat I stn Reemod under prevision,of Chalons, rcdra9(a mag JOB DESCRIPTION
=BOZO with Smimi700 )ofuivocion 3 oflhe Buslmaend PhdfiCeiom Ct IM my license is ' RESIDENTIAL
IIyy n full fmm and cRat PERMIT ISSUANCE.
Fy'WI. ❑Sll]WL ❑KTfCHFN RI!MODF1
a Utj htmnan 1"' APPLIANCES-RISIUfNP1Al. ❑ADDITION ❑PLUMBING R PIPE
F Z uI Dale TS DB
hn6a ❑A1ULThURIT El STRUCTURAL
ARCHRECTS DHCIARATION
PANES MODIFICATION
Z O,`�Z IutWenwrd my plan,stall be n,d republic reemds UP T02(MI AMPS
OZ—p ❑INTFAIOR ❑CHIMNEYRITAIR
I=.�Cw Licensed Prnfcommal ±01-I"AMPS IMPROVEMENT C]SWIMMING POOLS
OWNIR-BUILDU DECLARATION OVF.H I BOX1AMl'G ❑BATH RL'NODEURHPAIH [D DEMOLITION
1 herM1y nllimt that I am exempt Imre the Cmtmemr',license Lem cur the
O d V following acorn.f.SceHnn 911113.Bnsihxxx olid Ihu[wiom C'sdu:Any city a catnry SIGNS P1,I:G1'HICAi. ❑OCI{liR
3 n-� wroth requires a retainer to construct,alter,inpmve,demolish,or rcrair any Vora ure
Og peorn.as iastwrre,elrur�uiresdRaprlicaru forsuchpermit to fileusighaduatement SPECIALCIRCUITMISC. all I
an
Ihn he is liaaad pursuant to the mol Oe CodtsnAs Liccrcc Lew(cn,rter9
FErg}� rtotirin COMMERCIAL*
" C (ammcrcinguim Section N00)of Divisim3ofthe Rous ¢mdlY fcsi Cadc)er TEMP.M=R OR POIU?INST.
d d c e' thu he is exemp thichrmm and the tarots Lir me salaried eaenypim.Any imalfi n of NliW BLDG/ADDITION ❑DFJdOLITION
X�^N Smli.n10313hyanyaprlicentforspcmii(subjcecamcaplAicanllnecivilNnal(Yt)f POWFY DI?VICI?S TI?NANT C1 FOOD SI?RVICI:
> mm�re man Hvu hundrnd dollars(S.HIB), IMPROV EMEN'I'
FPQ D1.mowrcndthepngcnY�mmy corp!oYw*windw'a8o'ustheirvdecmgen.utiom, SWIMMING PO(A,ELECIRIC 0OTHF
�L will J"the work,coal thcunMuhc Lama initiated!tnnDe l furmle(Sn.]D0.Has'.,
W and Pmlewons Coca:TM1e Cmmaclm's Ldc.U.done,ma apply to m mxrcr of OUTLHTS-SWITCHES-FINTURES
a 3— faii who lds m improves therm,and wish done,wen horde nimseH. EE - C
his wn the!" cN provided ther such itrymncmcmx art w imclxYd sr oRchcd fa NEW RESTUI:NTIAL SQ FT
Safe,If.howc,er,Oc building orimphovemem is sold within orc year oI Zw Ifflc=the SQ.FIL FLUOR ARBA SISQ.IT.
name,haiMn will have Int Laden of proving ohm he did not mild us impmea Lr Pur-
1 'of'lc.), 'ITYL
L as wncr of art porrach,ant cxdusively cmtracting with lichna l eniumetou In
eommct Jsh peujeet[.tiee'10a4.Bads aril Pro[enionx Cak:)The Cmurc,cr'n lar
tenon law dots mtapply tomowmrof prorperty shim nuildamimrtovm thahon.axl QTY. PLUMBING PERMIT E
wM ttmhM4fm w[h pny[ct wlme[onlra[IoRS)IlttvAtd lntRYNlln rhe CvnlnYl Yr
!kerne Loa. PERMIT ISSUANCE
l an smmM reeler Sec. .B&P C fm this mason
ALTER-DRAIN AVENT-WN'IiH(PA) VAI.W\!'ION
[)are
war WORKER'S f COM of Nip,ma olefin AIION BACK FLOW i'R(TIECT.UL'VICii
1,achyalmaumdr pemhyor.fCo orco[mehohwing Wonsan"
Cro
�Il.as andwill me,byS Cerdf ate of fla,"b r Coca.sforefor Wmkcr's Comrm- DRAINS-h100R RWEAHI:\,COND. STORIES TYPECONSTNUCI'ION
ratio",as phI h hi foe by Smion 3]0(1 of 0e Labor Cale,for the pedmvurce of dee
fa wM1ich this paais ossa ct! LL FlVIS
NTR -PEA TRAP
w hath and will maintain W, effou con�e 0minn Irrvunrchi ac rquiral M1y Section
3 u[thh!near Oak,for perGxnwnce of Nc wtclo for which thi-,cannot rsiemM. GAS-I?A,SYSTEM-I INC.4OUTLETS UCC.GROUP / AI'pRY
MyW tea it Inuramccank+uM Policy l.J
Carritv` �.i1f.L—WIicY No
-Y ? GAS-HA,SY5TEh1-OVER 411?AI
"ERI IFIC OMPfi?SATIO I N FRANCIS ERS' GRIiASMNDUSTRL WASTE IN IACEPIDR
CO)1PFNSATION INSURANCE BUILDING DIVISION FEES
lTinsra'ction nerd not be compleedif the prsmir is for orc hutdml dollars($100) GRGSI: AP
mks*) PT.ANCHECK ITS r
Icenifydch in meperfommtc,Mthe work for.loch this permit is is sued.T Ball SEWI?R-SANI'I'AHY-STURM ILA,2110 FT
not employ Pm non m
any 'wm In any manna lar crouse suhn jeto m the Workers'Couna i-NEHCV ITE
ZZ .whim law ofCNilitmio.Uatc WAfHR 1 ILAHR WNRNTPUICIB GRADING IEE
o Appfcaut
N NOTICE TO APPLICANT:If,after nuking dais Cenitivae of Encmr ion.You*loud WATER SYSTI:N/TRIA'UNG
f^ " hcavne wh*t to tbt Woskhts Compcmuim Popo won of the Lahur Cod,.Year marl ME
forthwith crmrly wida such previsions this liana it dull re drumhead ra,-load. WATETI SrxVICF.
o
.7 Z CONSTRUCTION LL'NDING AGENCY NEW RESIDIl."DAI.P1,h1R. SQ.IT. r r
I horny illi nn that Chao is a conumctiu"lending ager y Lr dao perfmmncc M
L) If
O the wank for which dais permit i—mal(Ssx.3097.Co, .) T
it.
C) Lender's Norte
W lunateCs Ariel TOTAL: lar
F- y T tering trot 1 w.= dais appneaionn and stsa wh as sashes itdmmatinn i, Uu.DINc rEE
UN course,ling agreemrnmgy harm au cnYandcwoaa Raimrc<saW stuelaws«latnt the QTY. A1F.CHANICAI,VF,RMIT PEE
Z I,vilains�,tmetimt,and rtwyasmnrri.e htpr«awitmmthis dtytw ratter w,hn the setwe pee
ahtvc-Itscntiuhud Pnhpcny for impeder,purrtrsn. PERMIT ISSUANCE.
(Wc)agnea Or save.'mderoody un I keep harries,the Carry of Cupxloo a,lue,f 'EkIEINlCis�
1'abilmes.judgmemta,mus andextenws which may in any way uecroe ogabtst.aid City ALIER OR ADD TO MECH. PLUMBING ME
in mnaquanx of he grunting of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO IU.(WCFM) MECHANICALFEE
�,rn; liV Q, 12125191
AIR HANDLING UNIT COVER I0.(1(10 CFM) CONSTRUCTION TA%
Signature of ApplicanUCmtrxac Dam EXHAUST HOOD 1WNUCT) HOUSING MITIGATION PrI7.
HAZARDOUS MAI'I dUAl S DISCLOSURH
Will lbf applicant m future huiat'mg occupant vac or llandia havaMuua notarial HEATING UNIT TO IW.IVMI BTU)
es deLnmi by the Cupenirsh Municirtd Code,Chapter 9.12,had the Health and Safety
Calc.Smi.m 2553200' ' HEATING UNIT(OVER I00.000 BIL)
E3 Yes El No VPN"DIATION FAN(SINGLH RE STD) PAID Due Receiq♦
Will tla aprlicam or future handling omtpant use tunic ant or devices which BOILFR-COMP OHP OR IIXL(MX)BILL
all haaanhma air emtaminanu a defined by the Bay Arca Air Qualhy Mahugement TOT I l7�
)Luria'! BOILHR-COMP(OVER I D),IMXI It DUE
EJ Yes No
T nave real Be lacvn adooleach,reser.m under Charter 6.95 of the Cali AIR CONDITIONER ISSUANCE DATE
law Health A Salary Code.Section,25N)5,3533 and 255,.1 unvkeuad that if the NEW RFSIDEISTIAL NIECE]. SQ.FT. ,r1
SOBO g di art mhremly bave a hmant.that it it my^rsP""i.M1ity In thirty tic acvryvn !� �e4 vL v 9
1 tPnUr lU n1 TItKa1CU LYlV �a' V I
A la`I1�9
(Taocr or aulM1oti'red agent Uahc
TOTAL:
ISSUIiD BY:
OFFICE